The purpose of this study was to explore nurses' experience of evidence-based nursing practice in general hospitals.
Methods
Data were collected from 13 nurses through in-depth interviews about their experiences with evidence-based practice. The research questions were "What kind of evidence are you using in your practice?" and "What are the barriers to and enablers of evidence-based practice that you have experienced?" Qualitative data from field and transcribed notes were analyzed using qualitative content analysis methodology.
Results
Major themes of using evidence were identified as 'research as primary valid evidence', 'information from local context and internet as realistic evidence', and 'clinical experience as pragmatic evidence'. Patient experience was not used as evidence in solving nursing problems. Barriers to and enablers of evidence-based practice were linked. They included both external, organizational factors and individual factors. Main issues were 'lack of evidence and poor work environment', and major facilitating factors were 'improving knowledge and skills related to evidence-based practice' and 'communicating and sharing evidence'.
Conclusion
The study findings provide useful information for understanding nurses' experience of using external and internal evidence along with their meaning. A multidimensional approach is needed to overcome barriers to and implement evidence-based practice.
This work was supported by National Research Foundation of Korea - Grant funded by the Korean Government (NRF-2009-327-H00039).
REFERENCES
1. Brown CE, Wickline MA, Ecoff L, Glaser D. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. J Adv Nurs. 2009;65:371-381. http://dx.doi.org/10.1111/j.1365-2648.2008.04878.x
2. Craig JV, Smyth RL. The evidence-based practice manual for nurses. 2007;2nd ed. Philadelphia, PA, Churchill Livingstone.
3. Doran DM, Sidani S. Outcomes-focused knowledge translation: A framework for knowledge translation and patient outcomes improvement. Worldviews Evid Based Nurs. 2007;4:3-13. http://dx.doi.org/10.1111/j.1741-6787.2007.00073.x
4. Estabrooks CA, Floyd JA, Scott-Findlay S, O'Leary KA, Gushta M. Individual determinants of research utilization: A systematic review. J Adv Nurs. 2003;43:506-520. http://dx.doi.org/10.1046/j.1365-2648.2003.02748.x
8. Hwang JI, Lee SI, Park HA. Barriers to the operation of patient safety incident reporting systems in Korean general hospitals. Healthc Inform Res. 2012;18:279-286. http://dx.doi.org/10.4258/hir.2012.18.4.279
9. Kim JE. Comprehensive understanding of peri-menstrual discomfort: Methodological triangulation. 1995;Seoul, Korea, Seoul National University Graduate School. Unpublished doctoral dissertation.
10. Kim SY, Kim JK, Park KO. The role experience of preceptor nurses in hospitals. J Korean Acad Nurs Adm. 2012;18:33-45.
11. Kitson A, Harvey G, McCormack B. Enabling the implications of evidence based practice: A conceptual framework. Qual Health Care. 1998;7:149-158. http://dx.doi.org/10.1136/qshc.7.3.149
13. McInerney P, Suleman F. Exploring knowledge, attitudes, and barriers toward the use of evidence-based practice amongst academic health care practitioners in their teaching in a south African university: A pilot study. Worldviews Evid Based Nurs. 2010;7:90-97. http://dx.doi.org/10.1111/j.1741-6787.2009.00180.x
14. Melnyk BM, Fineout-Oveholt E. Evidence-based practice in nursing and healthcare: A guide to best practice. 2011;Philadelphia, PA, Lippincott Williams & Wilkins.
15. Melnyk BM, Fineout-Overholt E, Feinstein NF, Li H, Small L, Wilcox L, et al. Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Worldviews Evid Based Nurs. 2004;1:185-193. http://dx.doi.org/10.1111/j.1524-475X.2004.04024.x
18. Park HS. A study on accessibility, usefulness, barriers of evidence based nursing of clinical nurse. 2005;Daegu, Korea, Keimyung University. Unpublished master's thesis.
19. Park M. Understanding and application of evidence based nursing. 2006;Seoul, Koonja Press.
20. Rycroft-Malone J, Harvey G, Seers K, Kitson A, McCormack B, Titchen A. An exploration of the factors that influence the implementation of evidence into practice. J Clin Nurs. 2004;13:913-924. http://dx.doi.org/10.1111/j.1365-2702.2004.01007.x
21. Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B. What counts as evidence in evidence-based practice? J Adv Nurs. 2004;47:81-90. http://dx.doi.org/10.1111/j.1365-2648.2004.03068.x
22. Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22:63-75.
23. Sidani S, Epstein D, Miranda J. Eliciting patient treatment preferences: A strategy to integrate evidence-based and patient-centered care. Worldviews Evid Based Nurs. 2006;3:116-123. http://dx.doi.org/10.1111/j.1741-6787.2006.00060.x
24. Solomons NM, Spross JA. Evidence-based practice barriers and facilitators from a continuous quality improvement perspective: An integrative review. J Nurs Manag. 2011;19:109-120. http://dx.doi.org/10.1111/j.1365-2834.2010.01144.x
26. Turkel MC, Reidinger G, Ferket K, Reno K. An essential component of the magnet journey: Fostering an environment for evidence-based practice and nursing research. Nurs Adm Q. 2005;29:254-262.
27. Vratny AD, Shriver A. A conceptual model for growing evidence-based practice. Nurs Adm Q. 2007;31:162-170.
28. Yi J, Park M. Nurses' access & use of information resources and barriers & competency of evidence based practice. Korean J Adult Nurs. 2011;23:255-266.
Table 1
General Characteristics of the Participants
Table 2
Nurses' Uses of Evidence in their Practice
Table 3
Nurses' Perceived Barriers to and Facilitating Factors for Evidence-based Practice
Figure & Data
References
Citations
Citations to this article as recorded by
Effects of Nutritional Intervention in Long-Term Care in Korea Eunkyoung Kim, Hyunwook Kang, Nahyun Kim Journal of Gerontological Nursing.2017; 43(2): 55. CrossRef
Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors Eui Geum Oh, You Lee Yang, Jae Yong Yoo, Ji Yun Lim, Ji Hyun Sung Journal of Korean Academy of Nursing.2016; 46(4): 501. CrossRef
Factors Influencing Nurses’ Implementation of Evidence-based Restraint Use in Long-term Care Hospitals Myonghwa Park, Mi Hwa Park Journal of Korean Gerontological Nursing.2016; 18(3): 172. CrossRef
Factors Influencing of Evidence based Practice Competency and Evidence based Practice Readiness in General Hospital Nurses Seang Ryu, Yun-Sook Kim, Yun Hee Kim Journal of Korean Academy of Nursing Administration.2016; 22(5): 448. CrossRef
Factors influencing Evidence-Based Practice Attitudes among Undergraduate Nursing Students Mi-Hyang Choi, Young-Hae Kim, Hyun-Mi Son The Journal of Korean Academic Society of Nursing Education.2016; 22(3): 274. CrossRef
